TMPPM 2008 > Texas Medicaid Services > Independent Laboratory > Reimbursement

26.3 Reimbursement

The Medicaid rates for independent laboratories are calculated in accordance with 1 TAC §355.8081 and §355.8610, and the Deficit Reduction Act (DEFRA) of 1984. By federal law, Medicaid payments for clinical laboratory services cannot exceed the Medicare payment for that service.

As the result of the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982, independent laboratories are not directly reimbursed by the Texas Medicaid Program when providing tests to clients registered as hospital inpatients. Reimbursement must be obtained from the hospital.

These services cannot be billed to the client.

Refer to: "Reimbursement" for more information about reimbursement.